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目的通过低压脉冲发生器治疗顽固性梅尼埃病的短期临床观察,评价该方法的有效性和安全性,为其长期临床治疗提供依据。方法采用自身对照方法,对18例顽固性、活动性梅尼埃病患者患侧耳鼓膜置管及低压脉冲发生器治疗8周的效果进行观察。运用症状卡和6点功能评分进行眩晕发作和活动状况的主观评分;采用纯音测听、耳蜗电图和双温试验进行听力学和前庭功能评价。结果 18例患者低压脉冲治疗后较治疗前眩晕程度、发作频率、发作日及6点功能评分明显改善,差异有统计学意义(P<0.05);治疗后8周较治疗前耳蜗电图-SP/AP 比值明显减低,差异有统计学意义(P<0.05),双温试验水平半规管功能无明显变化;2例患者治疗后4周较治疗前纯音测听0.5、1、2、3 kHz 平均听阈改善≥10 dB,16例患者听阈无明显变化;12例患者治疗后8周较治疗前听阈改善≥10 dB,6例患者听阈无明显变化;平均6个月观察期内无明显并发症。结论低压脉冲发生器的短期治疗可以控制梅尼埃病眩晕症状、改善听力水平、无明显并发症及副作用。该方法可以安全、有效、非结构破环性地治疗梅尼埃病,可用于顽固性梅尼埃病外科手术及鼓室注药治疗前。
Objective To evaluate the short-term clinical observation of intractable Meniere’s disease by low-voltage pulse generator and evaluate the effectiveness and safety of this method for the long-term clinical treatment. Methods The self-control method was used to observe the effect of ipsilateral tympanic membrane catheterization and low-voltage pulse generator treatment in 18 patients with intractable and active Meniere’s disease for 8 weeks. The subjective scores of vertigo and activity were evaluated by symptom card and 6-point functional score. The audiology and vestibular function were evaluated by pure tone audiometry, electrocochleography and double-temperature test. Results Compared with before treatment, the eighteen patients had significant improvement in the degree of vertigo, seizure frequency, seizure and 6-point functional scores after low-voltage pulse therapy, with significant difference (P <0.05) / AP ratio was significantly decreased (P <0.05), and the function of semicircular canal at the two-temperature test level had no significant change. The mean hearing threshold at 0.5, 1, 2, and 3 kHz after 2 weeks of treatment Improvement of ≥10 dB, no significant change in hearing threshold of 16 patients; 12 patients after treatment 8 weeks before treatment to improve the threshold of hearing ≥ 10 dB, 6 patients with no significant change in the threshold; no significant complications within an average of 6 months observation period. Conclusion The short-term treatment of low-voltage pulse generator can control the symptoms of Meniere’s vertigo, improve the hearing level, no obvious complications and side effects. The method can safely, effectively and non-destructively treat Meniere’s disease and can be used for intractable Meniere’s surgery and tympanic injection before treatment.